A. Field of Invention
This invention pertains to a method for providing an accurate representation of a person's spine, and more particularly to the relative and absolute positions of the individual vertebrae of the spine based on images thereof. The invention further pertains to an apparatus for the obtaining said representation.
B. Description of the Prior Art
Various kinds of illnesses can be traced to deformations in the spines of patients. In order to obtain a prognosis for such illnesses, for many years standard practice has been to obtain images of the spines of patients and the visually inspect these images and review the patients' medical histories. Typically, deformations of the spine can be a result of a congenital condition, or can result from a severe trauma suffered during an automotive accident, a fall, a physical altercation, etc. Unfortunately, until now there was very little quantitative information available from such images (normally obtained from x-rays at several different angles with the patient standing or seating) and therefore a physician had to rely on anecdotal evidence and his years of experience to make a reasonably accurate prognosis.
Recently the American Medical Association (AMA) got into the act and issued their new Guides to the Evaluation of Permanent Impairment, 6th Edition in 2008. These guidelines require the medical field to adjust its procedures for specific standards of patient's/client's care. For most of the medical and legal practices these changes are difficult because there is no available technology to accommodate such changes. The present application addresses these issues at least as they relate to the evaluation and prognosis of spine-related matters.
More specifically, The Guides to the Evaluation of Permanent Impairment by the AMA (Sixth Edition) includes an Alteration of Motion Segment Integrity quantification. AMSI is included in calculation of impairment ratings and is as follows:
“A diagnosis of AOMSI in the cervical spine by translation measurements requires greater than 20% anterior or greater 20% posterior relative translation of one vertebra on another, on flexion or extension radiographs, respectively; or angular motion of more than 11 degrees greater than each adjacent level on the flexion radiograph.” Page 578 6th AMA Guides.
“A diagnosis of AOMSI in the thoracic spine by translation measurements requires at least 2.5 mm anterior or 2.5 mm posterior translation of one vertebra on another, on flexion or extension radiographs respectively; or successful or unsuccessful attempts at surgical arthrodesis, including dynamic stabilization.” Page 578 6th AMA Guides.
“A diagnosis of AOMSI in the lumbar spine (L1-L5) by translation measurements requires greater than 8% anterior or greater than 9% posterior relative translation of one vertebra on another on flexion or extension radiographs respectively.” Page 579 AMA Guides.
“In the lumbosacral spine (L5-S1), it requires greater than 6% anterior or greater than 9% posterior relative translation at L5-S1 of L5 on S1 on flexion or extension radiographs, respectively. A diagnosis of AOMSI in the lumbosacral spine by angular motion measurements requires greater than 15 degrees at L1-2, L2-3, and L3-4; greater than 20 degrees at L4-L5, or greater than 25 degrees at L5-S1 (compared with adjacent level angular motion)” Page 579 6th AMA Guides.
Since it is so much time consuming and inaccurate, as well as inter-operator inaccurate (if it is done with a ruler and a pencil) the measurements are always subject to significant errors. Various solutions have been suggested to perform the calculations using automated means, however, the inventor has found that all of these suggestions suffer from one or more of the following short comings:
After extensive studies with different models numerous inborn flaws were found, specifically:
a) Lack of precision due, for example, to changes in magnification of images and angular optic distortions;
b) Improper segmental quantifications
c) Are not updated with the new standards set forth by the AMA 6th Edition
d) many unnecessary features included in some of the devices make the devices difficult and cumbersome to use;
e) improper angle quantification due to magnification and optical angular distortion of the image as well as improper geometrical point designation;
f) invalid claims of calculation of the impairment rating
g) illegally sold devices are not be cleared by the FDA for sale (DX Analizer Professional), but presently sold have numerous inherent software flaws;
The apparatus and method disclosed here in overcomes all these problems.